Crit Care Nurs Clin N Am 18 (2006) 433–439

Index
Note: Page numbers of article titles are in boldface type.

A in terrorist events, 333

Abdomen, organs in, classification of, 388 mechanism of, 333–335
sections of, 388 pathology and management of, burns in, 343
chemical, biologic, or toxic gas exposure in,
Abdominal compartment syndrome, 397
343
Abdominal/pelvic injury, in older adult, 422 crush injury, 343
fluid and blood resuscitation in, 344
Abdominal trauma, anatomy of abdomen in,
in arterial gas embolism, 339
387–388
in intestinal injury, 339–340
penetrating. See also Penetrating abdominal
in neurologic injury, 340–341
trauma (PAT).
in otologic injury, 340
versus perforating, 387–388
in primary blast lung injury, 337–339
Accidental injury, of pregnant women, 273 ocular trauma in, 342–343
Addiction, 373 pain management in, 344
psychologic trauma in, 343–344
Adjustment disorder, in combat veterans, 351 soft tissue trauma in, 335, 341–342
Airway, in shaken baby syndrome, 282–283 traumatic amputation in, 341
primary, 333–334
Alcohol use, and motor vehicle-related trauma, blast wave in, 334
375 exposure to high-order explosion, 333–334
Amputation, traumatic, in blast victims, 341 in open-air explosions, 336
pattern of injuries and, 336
Arterial gas embolism, in blast lung injury, 339 pressure wave in, 334
risk for, 336
B victim in water, 336
Ballistics, bullets in, movement of discharged, 322 victims at risk for, 335–336
types of, 322 quarternary, 334–335
caliber in, 321 secondary, 334–335
definition of, 331 blast wind in, 334
gauge in, 321 example of, 334–335
magnum in, 321 pain management in, 344
weapons and, 321–322 soft tissue trauma in, 335
wound types in, 322 tertiary, 334
blast wind in, 334
Biologic exposure, in blast victims, 343 blunt trauma injuries in, 335
Blast injuries, from suicide bombing, 344–345 pain management in, 344
bone fragments in, 345 to lung, 334, 336–339. See also Blast lung injury
prophylaxis in, 345 (BLI).
from triage to critical care of, 333–348 triage of, categories of, 336–337
in industrial events, 333 in exposure to chemical, biologic or
initial emergency department management, radiologic agents, 336
336–337 types of, 333–335

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434 INDEX

Blast lung injury (BLI), example of, 336 Emotional abuse, intimate partner and, 288
primary, assessment of, 338 of elders, signs of, 314
chest radiograph in, 338
death following, 334
F
initial care in, 339
management of, 338–339 Falls, traumatic injury from, in older adult, 418
pathology of, 337–338 Fetal loss, following maternal trauma, 273
severity score for, 338–339
risk for, 336 Fire and smoke injuries, 403–417. See also
Thermal/flame burns.
Blood resuscitation, of blast victim, 344 burn center referral in, 403–404
Blunt trauma, in intimate partner violence, 288 burns in, 414–415
critical care management in, 412
Burn injuries, 412–413 epidemiology of, 403
Burns, in blast victims, 343 hospital admission in, 403
management of, care at scene, 411
Burn shock, 409 emergency room care in, 411
fluid resuscitation in, initial, 411–412
C gastric decompression in, 411
pain control in, 412
Central nervous system injury, from blast wave,
psychosocial care in, 412
340
wound care in, 412
Chemical exposure, in blast victims, 343 nutritional support in, 413
Chest injury, in older adult, 424 caloric requirements in, 413–414
fat in, 414
Chronic health conditions, in older adult, glucose in, 413–414
424–425 minerals and trace elements in, 414
Coagulopathy(ies), shaken baby syndrome versus, protein-containing nutrients in, 414
284 vitamin supplementation in, 414
pain control in, 414–415
Cognitive deficits, in shaken baby syndrome, 283 thermal/flame burns, 403–405
Combat. See also Military duty. wound management in, early excision and
psychosocial effects of, 349–356 grafting, 412–413
escharotomy in, 413
Crush injury, in blast victims, 343
sequelae of, 343 Firearm injury and death, comparison with
industrialized societies, 298
CT scan, in shaken baby syndrome, 281 costs of, 298
years of life lost from, 298
D incidence in U.S., 297
Dementia, in sexual abuse of elder patient, intent of, interpersonal, 298–299
317–318 self-inflicted, 299
unintentional, 299
Depression, comorbid with PTSD, in combat risk factors for, 299, 301
veterans, 352 suicide in, 297–298
Domestic violence, during pregnancy, prevention Firearms, penetrating head injury from, 321–332
of, 276–277 wounds from, 322
pregnant women and, 273 careening, 322–323
Drug abuse. See Substance use disorder. penetrating, 323
tangential, 322

E Firearm violence, as health problem, 297–303

community examination of, 300–301
Elder abuse, types and signs of, 313–314
environments in, 299–300
Elder sexual abuse, 313–319 reduction of, 301
 INDEX 435

Fluid resuscitation, in fire and smoke injuries, patient care management in, danger
initial, 411–412 assessment in, 293–294
in thermal/flame burns, choice of fluid, 410 safety planning and, 293–294
rate of administration in, 410–411 screening for, barriers to, 290–292
of blast victim, 344 ED programs for, 292
in primary practice, 292
on obstetric unit, 292–293
G
problems in, 290
Glucose, in burn injury, in nutritional support, programs to increase, 292–293
413–414 routine in women seeking health care,
metabolism of, 409 289–290, 293
universal versus incident-based, 289–290
H sharp force injury in, 293
Head injury, from secondary and tertiary blast, social isolation and, 288
340–341 substance abuse and, 289
in older adult, 422 types of, 288
victim denial of, 291
Hearing loss, from blast wave, 340
Intracranial hypertension, in shaken baby
Hematoma, in head injury, in older adult, 422 syndrome, 283
Hemorrhage, from stab wound to head, 323–324 Intracranial injury, in penetrating head injury, 325
retinal, in shaken baby syndrome, 280 in shaken baby syndrome, 279–280
subarachnoid, 325
Intracranial pressure, in penetrating head injury,
Homicide, as femicide, in intimate partner management of, 327–328
violence, 289 pathophysiology of, 323
elder women patient victim of, 315
firearm, community effects of, 299, 301
firearms in, 298 L
intimate partner violence and, 289 Lumbar puncture, in shaken baby syndrome,
substance abuse and, 375 281–282

I
Intestinal blast injury, 339–340
diagnosis of, 340
Intimate partner violence, Abuse Assessment
Screen in, 291
abuser in ED with victim, 291–292
as public health problem, 287–288
blunt force injury in, 288, 293
blunt trauma in, 288
definition of, 287
documentation of, 291, 293
during pregnancy, 273, 276–277
forensic aspect of care, 293
health problems associated with, 288–289
implications for critical care nursing,
287–296
in ED visits for women and female homicides,
287
mental health symptoms in, 288–289
murder in, 289
overview of, 287–288
overweight and obesity in, 289
M
Major depressive disorder, in combat veterans,
351
Mandatory reporting, and screening for intimate
partner violence, 290
Medications, contributory to delirium, in older
adult, 427–428
Mental health problems, military duty-associated,
350–352
Mental status, in shaken baby syndrome, 283
Mild cognitive impairment (MCI), in sexual abuse
of elder patient, 317
Military duty, mental health problems associated
with, 350–352
acute stress disorder, 350
mediating factors in, 353–354
PTSD, 350–351
of nurses, compassion fatigue in, 354
stressors related to, 349–350
436 INDEX

Motor vehicle accidents, substance abuse and, 375 observation in, 392–394
survivorsÕ guilt in, 360, 363 wound exploration in, stab wounds in, 392,
traumatic injury from, in older adult, 420–421 394
damage control surgery in, 397
diagnostic testing in, angiography in, 390
N
computed tomography scans in, 390
National Institute for Occupational Safety and diagnostic peritoneal lavage in, 390
Health, workplace violence definition, 306 laparoscopy in, 390
Neglect, of elders, signs of, 314 laparotomy in, 391
radiographs in, 389–390
Neurologic injury, from blast wave, 340
ultrasound in, 390
laboratory studies in, PT/PTT, 392
O type and screen, 391
Obstetric patient, trauma in, 273–278 mechanism of, 387
review of, 393–394
Occupational Safety and Health Administration,
selected injuries in, 394–397
workplace violence definition, 306
pancreatoduodenal, 395
Ocular trauma, from blast wave, 342–343 to bladder, 396
to gallbladder, 395
Organ donation, following traumatic loss, 366
to kidney, 396
in brain death, from penetrating head injury,
to kidney/ureters, 395
329–330
to liver, 395
Osteogenesis imperfecta, skeletal fractures in, to major blood vessels, 394
shaken baby syndrome versus, 284 to peritoneal cavity, 394–395
to retroperitoneal space, 394
Otologic injury, from blast wave, 340
to small bowel, 396
to spleen, 395
P to stomach, 396
Pain management, in blast injury, 344 to uterus, 396
in burn care, 412 treatment of, historical review of, 392
in fire and smoke injuries, 414–415
Penetrating head injury
in older adult, with abdominal and pelvic
ballistics in, 321–323
injuries, 424
brain death in, and organ donation, 329–330
Parental education, in prevention of shaken baby diagnosis of, 325–327
syndrome, 284–285 head-to-toe assessment in, 326
neurologic examination in, 325–326
Penetrating abdominal trauma, case studies,
radiologic assessment in, 326
President Garfield, 398–399
two-weeks postinjury, 326–327
President McKinley, 399–400
exsanguination in, 323–324
Penetrating abdominal trauma (PAT), assessment from high-velocity versus low-velocity missile,
of, 387–388 323
auscultation in, 389 in critically ill patients, 321–332
grading scale for injury to organs, 391 instruments in, 321
inspection in, 388 intracranial pressure in, 323
palpation in, 389 intracranial pressure management in,
percussion in, 389 nonpharmacologic, 327
complications of, abscesses, 397 pharmacologic, 327–328
infection, 396–397 management of, cardiovascular interventions
peritonitis, 397 in, 328
prevention of, 396–397 collaboration in, 327–329
current management of, basic approach, 392 endocrine interventions in, 328–329
computerized tomography in, 394 genitourinary, 328
laparoscopy in, 394 guidelines for, 327
 INDEX 437

musculoskeletal, 329 R
nutrition in, 328 Resuscitation and fluid management, in thermal/
psychosocial, 329 flame burns, choice of fluids, 410
pulmonary interventions, 328 rate of administration in, 410–411
skin/wound and infection, 329
mechanisms of, 321–323 Retinopathy of prematurity, shaken baby
pathophysiology of, arteriovenous fistulas, syndrome versus, 284
325
cerebrospinal fistulas from, 325 S
cranial nerve injury from, 325 Sexual abuse, in elder patient, assessment of, 319
infection from, 325 detection of, 318
intracranial dynamics, 323–324 in critical care settings, in-service programs
seizures from, 325 for, 319
subarachnoid hemorrhage, 325 protocols for detection of, 318
traumatic aneurysm in, 325 of elder patient, assessment of injury in,
prognosis and ethical considerations, 315–316
329–330 risks for, 317
seizures in, antiseizure prophylaxis and, 328 study of, 314–315
settings in, 321 murdered women in, 315
versus perforating wounds, 323 survivors in, 315
Penetrating injuries, instruments in, 321 suspected cases of, 316–317
of elders, signs of, 313–314
Penetrating injury, versus perforating injury, of elders, in critical care settings, 313–319
387–388 of intimate partner, 288
Perforating injury, versus penetrating injury, Sexual violence, intimate partner and, 288
387–388
Shaken baby syndrome, 279–286
Perforating wounds, penetrating wounds versus, clinical findings in, 280
322, 323 clinical presentation of, 281–282
Physical abuse, intimate partner and, 288 diagnoses that mimic, 284
of elders, signs of, 313 epidemiology of, 280–281
initial hospital management of, 282
Posttraumatic stress, in older adult, following in racial and ethnic minorities, 280–281
traumatic injury, 421 intracranial injury in, 279–280
Posttraumatic stress disorder (PTSD), in combat retinal hemorrhages in, 280
veterans, 351 mechanism of injury in, 279–280
anger and violence in, 353 mortality from, 280
literature review of, 352 nursing management of, airway, 282–283
in female veterans, 353 intracranial hypertension, 283
mental status, 283
Pregnancy, major system changes in, implications outcome and sequelae, 283
in trauma, 274–276 pathophysiology of, 283–284
medical management of, 277 perpetrators of, 280
Psychiatric illness, comorbid with dementia, in prevention of, 284–285
sexually abused elder, 318 research and, 284
Psychologic trauma, in blast victims, 343–344 Skeletal survey, in shaken baby syndrome, 281
PTSD, domains of, 351 Social isolation, intimate partner violence and,
following traumatic brain injury, 344 288
Public health problem, firearm violence as. See Soft tissue trauma, from dirty-bomb explosion,
Firearm violence management of, 341–342
intimate partner violence as, in blast victims, infection in, 341–342
287–288 mangled extremities, 341
438
Spinal cord injury, in older adult, 422, 424
cascade iatrogenesis and, 424
osteoporosis and, 424
Stab wound. See also Wounds.
to abdomen, 392, 394
to head, 323–324
Strangulation, intimate partner and, 288
Substance abuse, association with trauma,
determinants of, 378–379
genetic familial history in, 378
improved care in, evidence-based
conclusions for, 379–382
neuroadaptation and, 378–379
neuroreinforcement and chronicity in,
378–379
nursing care and, 375–379
correlates of care, 378–379
directionality and, 378
temporal considerations in, 376–378
tolerance and withdrawal in, 379
screening for, 379–381
biologic markers in, 381–382
brief motivational interviewing, 382
demographics and, 380
instruments for, 380–381
predictive of homicide-related behavior, 375
Substance dependence, characterization of, 373
Substance use, in trauma, categories of, 373–374
prevalence of, 374–375
trauma-related, semantics in, 371–374
Substance use disorder, 373
characterization of, 373
Substance use disorder/alcohol use disorder, in
combat veterans, 351, 353
Suicide, failed, survivor’s guilt in, 360–361, 363
firearms in, 297–298
community effects of, 299, 301
in older adult, risk factors for, 421
risk factors for, 299
Suicide bombing, blast injuries from, 344–345
SurvivorsÕ guilt, case studies, failed suicide,
360–361, 363
loss of mother/grandmother babysitter,
361, 363
motor vehicle accident, 360, 363
following traumatic loss, 359–369
actualizing the loss in, 364–366
guided imagery in, 364
personal strengths in, 364–365
INDEX
reflection and clarification in, 365
affective responses in, distorted, 366
creative outlets for, writing, 366
creative outlets for resolving, art, 366
disequilibrium in, 366
emotional and behavioral manifestations
of, in CCU, 361
establishing rapport with family members,
363
irrational guilt in, challenging, 365
naming guilt in, 363
organ donation in, 366
promotion of adaptive coping and
functional grieving, 362–363
physical environment for, 362
positive regard for thoughts, emotions,
of family members, 362
promotion of adaptive coping and
functional grieving in, questions and
reflections of feelings in, 363–364
providing information for, 366
providing resources for, 365–366
identifying family support systems as,
366
working with, 361–362
T
Thermal/flame burns. See also Fire and smoke
injuries.
classification of, deep partial-thickness (second
degree), 404–407
epidermal (first-degree), 404–405
full-thickness (third-degree), 405, 407–408
superficial partial-thickness (second
degree), 404–406
depth of burn, 403
assessment of, 405
fluid resuscitation following, choice of fluids in,
410
rate of administration in, 410–411
immunologic response to, 408
inhalation injury in, 405–409
carbon monoxide poisoning and, 405–406
diagnosis and treatment of, 406
smoke inhalation, 407–408
diagnosis of, 408
treatment of, 408–409
thermal airway, 407
tracheostomy in, elective, 409
metabolic response to, glucose metabolism in,
409
lipolysis in, 409
proteolysis in, 409–410
 INDEX 439

neuroendocrine response to, 410 general, 425

physiologic response in, burn shock, 409 cardiovascular response to, 422
glucose metabolism and, 409 costs of, human and financial, 419
immunologic, 410 delirium in, medication-associated, 427–428
lipolysis and, 409 risk factors for, 425–426
metabolic effect, 409–410 screening for, 425–426
neuroendocrine, 410 head injury, 422
proteolysis in, 409–410 implications of aging in, 421–423
resuscitation and fluid management in, from head to toe in, 421–422
410–411 normal aging changes and implications for
size of, ‘‘Rule of Nines’’ and, 404 injury, 423
posttraumatic stress in, 421
Toxic gas exposure, in blast victims, 343
risk factors for, 420–425
Trauma, abdominal, 387–401 falls, 420
definitions of, 373 motor vehicle accidents, 420–421
during pregnancy, and abruption, 274–275 spinal cord injury, 422, 424
case study of, 276
Tympanic membrane rupture, from blast wave,
coagulation studies in, 275
340
Kleihauer-Betke test in, 275
major system changes and implications of,
274–276 W
management of, 274–276 Workplace violence, aftermath of, 311
nasogastric tube placement in, 275 case examples of, 306–307
oxygen supplementation in, 274 definitions of, 305–306
positioning in, 274 in health care agencies, 305
prevention of, 276–277 primer for critical care nurses, 305–312
radiological procedures and, 275 risk factors for, 307
in older adult, 419–431 types of, criminal intent, 306–308
obstetric patient and, 273–278 customer/client/patient/family members of
epidemiology of, 273 clients/patients, 305, 308
substance use and abuse in, 371–385 personal relationships, intimate partner,
substance use patterns in, 373 306–307, 310–311
Traumatic brain injury (TBI), in older adult, 420 verbal threat, 306, 308–309
substance use-related, 375 worker-on-worker, 309–310
Traumatic events, in combat duty, 352 Wound care, in penetrating head injury, 329
of burns, 412
Traumatic injury, in older adult, 419–431,
421–423 Wounds. See also Stab wounds.
ABCD in, 422 from firearms, 322–323
assessment of hospitalized, delirium in blast injuries, 333–335, 341–342
screening in, 425–426 perforating versus penetrating, 322–323